时间治疗学抑制老年高血压患者血压晨峰的研究

目的按照高血压时间治疗学中的择时给药，探讨不同的给药时间对老年高血压患者血压晨峰的影响。方法采用180-EA动态血压监测系统动态血压监测法筛选出206例有血压晨峰的老年高血压患者，随机分为A组采取常规的上午8时给药；B组采取晚上睡前给药，共治疗4周。治疗前后均进行动态血压监测的检查。结果治疗前两组的24h平均血压、白天平均血压、夜间平均血压以及血压晨峰均元统计学差异（P〉0．05）；治疗后两组的24h平均血压、白天平均血压、夜间平均血压以及血压晨峰均明显下降，与治疗前比较有统计学差异（P〈0．01）；治疗后B组的夜间血压及血压晨峰下降明显，且能恢复昼夜节律与治疗后的A组比较有统计学差异（P〈0．01）。结论对明显有血压晨峰的老年高血压患者，采取时间治疗可以更好的纠正夜间高负荷血压、抑制血压晨峰、恢复血压昼夜节律。

Study of restraining effect of chronotherapeutics on morning blood pressure surge in elderly patients with hypertension

Objective To investigate the influence of different drug delivery time on the morning blood pres- sure surge（MBPS） in elderly patients with hypertension in accordance with the time of drug delivery of chronothera- peutics. Methods With 180 -EA ambulatory blood pressure monitoring system, the ambulatory blood pressure mo- nitoring method was used to screen out 206 patients with MBPS from elderly patients with hypertension. The 206 pa- tients with MBPS were randomly divided into group A and B. Routine treatment of drug administration at 8：00 AM was taken by group A, while evening bedtime administration was used in group B which lasted four weeks. Before and after treatment, ambulatory blood pressure monitoring inspection were carried out. Results Before treatment, there was no significant difference in 24 h average blood pressure, daytime average blood pressure, mean blood pressure at night and morning blood pressure surge between two groups （P 〉 0. 05）. After treatment the 24 h average blood pressure, daytime average blood pressure, mean blood pressure at night and morning blood pressure surge of the two groups were significantly decreased. Compared with the data before treatment, there was a significant difference （P 〈 O. 01 ）. After treatment Group B＇ s blood pressure at night and morning blood pressure surge decreased significant- ly, and compared with the data after treatment of group A, there was a significant difference （P 〈 0.01 ）. Blood pressure of group B resumed circadian rhythm. Conclusion It is better to take chronotherapeutics to correct the high load of blood pressure at night, to restrain the morning blood pressure surge, and to restore the circadian rhythm of blood pressure of obvious morning blood pressure surge in elderly patients with hypertension.